The pathogenesis, protection and treatment for the bone-cartilage lesions in various internal derangement of the knee

本文对膝关节紊乱症骨软骨损害进行了实验和临床研究。生物力学实验采用猪膝关节股骨髁关节端。关节面在120 ° ~ 15 °角处受不同载荷条件下的剪切力。将实验性骨-软骨复合体损伤分为8种类型，发现剪切力作用下骨-软骨损伤有两种类型。一种是高速损伤，即软骨的外部损伤而没有内部损伤。另一种是低速损伤，无外侧损伤。这两个过程最终都造成了软骨和骨骼的破坏。实验数据很好地解释了临床软骨-骨病变的发病机制。软骨-骨交界处的开放性劈裂和开放性软骨下骨折与髌骨脱位中的骨软骨骨折相同。未钙化软骨的闭合性分裂可能是软骨软化症的肿胀性病变。部分闭合性软骨下病变可发展为剥脱性骨软骨炎。

In this series, We carried out the experimentalnd clinical study of bone-cartilage lesions in the derangement of the knee. In thebiomechanical experiment, the articular enda of the femoral condyle of the pig knees were used. The shearing force under the various loading conditions was givenon the articular surface at the angle of 120 15 degerees. The experimental lesions of the bone-cartilage composite was classified into 8 types and we found that there were two types of processes of bone-cartilage lesions by shearing force. One was the high speed lesion, that was outside lesion of cartilage without the inside damage. The other was the low speed lesion without out side damage. And both process evebtually produced both cartilage and bone destruction. The pathogenesis of the clinical cartilage-bone lesions was well explained by the experimental data. Open splitting at cartilage-bone junction and open subchondral fracture were identical to the osteochondral fracture, that was seen in the patellar dislocation. The closed splitting of uncalcified cartilage was possible to be the precursive lesion of chondromallacia. Some of the closed subchondral lesions may develope theosteochondritis dissecans.